August 25, 2006

Are we fat because we're prosperous? I've been assuming the "obesity epidemic" -- hmmm, what if it were contagious? -- is mostly a result of affluence. It's easy to get food, and we can relax a lot physically. We don't have to exercise to get our food, and we have lots of time sitting around not only not exercising but in a good position to eat the food that's always available. It's totally normal, under the circumstances, to get fat. You have to fight nature to avoid getting fat. Anyway, that's my casual observation.

At the link, economist Darius Lakdawalla debates the question with public policy professor Carol Graham. A key issue is why poor people are fatter than rich people.

Graham: While it is extremely difficult to precisely isolate the effects of norms and expectations versus those of cheap food and sedentary lifestyles, it seems very plausible that differences in the former set of factors play some role in explaining differences in incidence. Our research suggests that stigma against obesity is much lower in some racial, socioeconomic, and professional groups than others, and that accords with the higher obesity rates among those groups. It also suggests that obese people are less likely to experience mobility into higher status professions where obesity is rarer....Lakdawalla: [I]ncentives explain the variation between rich and poor at least as well as social norms. The seminal work of Michael Grossman, in 1972, argued that richer and more educated people have higher demands for health, because they stand to lose morein the way of lifetime income if they die young. Dr. Graham's examples make this point as well. For instance, she cites recent work by Jay Bhattacharya and Kate Bundorf that shows "discrimination against overweight and obese individuals is higher in higher status professions." In fact, Bhattacharya and Bundorf argue that people with health insurance face a larger wage penalty if they are obese, because their employers end up paying for their higher medical costs. They rely on incentives, not social norms, in explaining the phenomena they observe. Incentives also have several important practical advantages over social norms. Norms-based theories always involve a "chicken-and-egg" type problem. Are people fatter because it is more acceptable to be fat, or did it become more acceptable when more people got fat? Finally, and perhaps most importantly, it is often difficult to act on a theory of social norms, because policymakers can change incentives much more easily than social norms.

32 comments:

It's not just affluence, it's that our food is unbelievably cheap, relative to other expenses. When I visited eastern europe, I was startled by how much more of their income families have to spend on food (while housing was inexpensive by American standards).

I wonder what would happen to prices if we eliminated all the agricultural subsidies? Not a popular idea in Wisconsin, I know.

I agree with Jim. When food is expesive, fat is indicia of being rich. But food is so cheap here that you can be very poor and still very fat.

So, to a very great extent it seems like we have the opposite here - thin indicates wealth and success, not fat. I have heard posited that it may because all those health clubs, healthy food, etc. cost more money. Not sure, but we really do have an inverse relationshipo here.

I've also noticed that very few high school valedictorians are overweight. Ditto the Scripps-Howard spelling bee kiddies. A correlation between scholastic aptitude and weight? I'd be interested to know the grades/GPAs of demonstrably overweight kids.

Food is simply the most observable way we self-medicate. It is also the cheapest, and in many ways, about the least debilitating. Sure the long term effects are undesirable but few of us look that far down the road. I feel bad about myself today so my choices are to a: buy that yatch I've had my eye on, b: buy that 52" plasma screen, c: break down and get that new Kate Spade bag, d: get some coke (a great way to keep one's weight down, btw,) e: order up a chocolate martini, or f:eat two cartons of Cherry Garcia. Not saying is is good or bad. It just is. Especially among people who cannot see their lives improving in any significant way in the future. "I cannot afford to get what I really want so I'll get this food that makes me feel good." Thus fat people who are also poor.

Also, chips and cookies are a great way to shut kids up, have you noticed?

If I may adipose a question: Which came first- the chicken that was hatched, fed, slaughtered, then cooked at your homestead or near enough by where you walked to market to buy the dead bird and assorted other unprocessed foods to cook for your family... or the drive-through egg-McMuffin?

It's not so clear, when the rich used to be beautiful fat-cats and the poor lean and hungry, and these days affluent suburbanites are hard-bodied moms with pudgy television-video kids, and the underclass hopelessly lard-bellied or substance abuse emaciated.

Not only is food incredibly cheap relative to our cost of living, but the cheapest foods are loaded with empty calories....suagar and white flour cost next to nothing. Richer people tend to eat better foods.

People have been looking at obesity this way for years without success, but the new en vogue theories are that it's more the food, not people's behaviors toward the food. Seems plausible to me. The most expensive foods these days are the least processed.

I think this is an important point especially if 'better' means 'more nutritious.' In general, when a body's nutritional needs are met, hunger subsides. Less hunger > fewer calories stored. Don't wealthier people tend to be better educated about such things as nutrition and exercise?

I agree with Chris. Its not just that food is cheap and we are rich. Its that the available cheap and easily prepared food is really fattening and the least affluent members of this affluent society are more likely to rely on those cheap and fattening sources of food.

HFCS (High Fructose Corn Syrup) is a boon to manufacturers, because it stimulates the taste buds to want more, and eat ever more foods.....be more tempted to buy more of the manufacturer's product....which might be dirt cheap (affordable to the poor) to begin with.

Even Mexican don't put HFCS in their soft drinks. They won't use HFCS---they say it tastes like plastic. The Mexicans use real sugar; even that would be better than HFCS.

Lord save us from sociologists, the most psuedo of the psuedo sciences.

There are exceedingly few truly poor people in America anymore. If you want to study the truly poor, you have to find certain pockets in America, or travel to other countries. And, yes, the truly poor are generally quite lean. Most of the folks we call poor in America have TVs, VCRs, cell phones, and refrigerators stocked with high-fat, low-nutritional-value, preprocessed foods. And cheap beer. The rich eat better food, are more conscious of what they're eating, and can afford a gym membership. (Although a surprising number of the poor I've worked with have gym memberships somehow, too.)

People who are a bit more disciplined, ambitious, energetic, or intelligent - or some combination of these traits - than average, are also more likely than average to make the effort it usually requires to stay in good shape. Just by sheer coincidence, these same people also tend to be more affluent. No need to describe all the people you know who are exceptions to this, I know plenty of them myself. Just sayin' it might trend out.

Another factor, I suspect, is that lower economic groups are more likely to have unenjoyable jobs, which leads them to prefer less strenuous leisure activity, so they don't like to excersize and FORGET about dieting (a much bigger headache than excersizing, IMHO).

Agreed with michael h -- the true poor in the US are not fat, but it's a lot harder to find true poor. The definition of poverty has been defined upward over the years, and today's working poor are by the standards of a hundred years ago doing pretty damn well for themselves.

brenden - I'd say that the obesity of college students is around the same level as their peers who don't go to college. Valedictorians don't count - that's as much of a popularity contest as anything else, I thought.

Christy's point about food being used as "self-medication" is well-taken, IMO. I know that it's part of why I'm overweight myself. There are two types of people: those who eat more when depressed or stressed, and those who eat less. Those in the first group, I suspect, make up a large proportion of the obese.

I lost 10 pounds this summer, when I worked in Manhattan, and commuted by foot and subway. Also, the fact that it was so brutally hot probably meant that I had less of an appetite. I didn't work out once all summer -- the weight just came off. When I'm in law school in Madison, I commute by bus or by car, and don't walk around as much during the day as I did in NYC. Americans today live in endlessly sprawling suburbs, and more and more office space is being moved to large, single-level suburban office parks, which have their own parking lots. Few people who don't belong to a gym walk more than a mile or so in the course of a day, whereas a New Yorker probably walks at least three or four times that. Some people walk 20 blocks just to get to the subway. That doesn't happen in Madison, or in my hometown of Buffalo. The middle and upper classes can afford gym memberships, but not everybody can. This is not to be underestimated -- most of my friends who worked at corporate firms joined gyms this summer, when I and most of my fellow non-profit friends couldn't afford to do so.

Maxine - I agree. On a recent trip to Panama, I noticed how much better the Coke tasted there than in the U.S. The reason is that they use actual sugar from actual sugarcane, instead of HFCS. Drinkers of regular soda probably gain five pounds every couple of years from sugary beverages alone.

Maxine's comments only make sense if you can ignore the obesity rates among Mexicans. IANAE, but apparently Coca-Cola comes in 2nd only to the Virgin Mary in Mexican culture. It is all the rage to blame HFCS on obesity. Sugar is just as bad.

The easiest way to manage weight without a lot of contrived dieting is to eat healthy, fresh food with no additives such as corn sugar and trans fats. Healthy food is pretty expensive in terms of median income.

The easiest way to make your weight soar and pick up lifestyle diseases like Type 2 diabetes is to eat crappy food loaded with corn sugar and trans fats. That food is incredibly cheap.

Given these everyday realities, it doesn't seem to take a lot of analysis to figure out why affluent people are thinner than poor people. (Not a lot of fat people at Whole Foods, and not a lot of poor people, either.)

I used to work at one of the US sugar refineries that has been closed down by the general switch to HFCS. If you like soft drinks made with real sucrose, you have a window of a few weeks before passover to buy "kosher for passover" stuff. All made with genuine cane sugar. We used to get real busy for a few weeks before it came out.

The HFCS thing was mostly caused by agricultural import tariffs. Without such interference, cane sugar is about the same cost as corn syrup and would probably be used in everything. Instead, raw cane sugar is roughly triple the cost in the US as it is everywhere else (about 21 cents/pound vs. 7 cents elsewhere)

The fact that we can eat more calories for less is one of the greatest acheivements of human civilization. Even one hour of labor at minimum wage can buy one pound of ground beef, five pounds of pasta, or a week's worth of calories in sugar water. Even less than 100 years ago, the average American couldn't have imagined feeding oneself so easily. Over half of the population of the world still can't imagine this.

We live in a country with industrialized food, and we should count ourselves lucky.

When I lived in the suburbs in Maryland I had a neighbor who religiously went to the local gym which was located 2 blocks away. He got in his car and drove the 2 blocks to the gym, worked out, came out of the gym, drove another 2 blocks to the liquor store, bought his case of beer, drove the 4 blocks home and vegged out in the back yard with his case of beer. Ludicrous!!

When I was younger, about 20 years ago, I lived in Manhattan and thought nothing of walking home from 52nd street and 5th avenue just above Rockefeller Center down to the edge of Greenwich Village. It was a pleasant 45 minute walk and I felt very good afterwards. Now I live in Queens and I have a 6 block walk to the bus or the subway. Don't even have a car and the things would be a problem if I did. Where do you park it and how do you make sure you keep track of the hours you can park on one side of the street or the other. It is just a hindrance here. Take a shopping cart and stroll over to the store and then stroll home.

Madison Guy: I was at Whole Foods yesterday, and there were plenty of fat people. But I do agree that your chances of getting healthy food are higher there. Still, there's plenty of junk food too. You can get sugary soda -- and if you think sweetening with corn sugar rather than beet or cane or whatever sugar makes a difference, I think you're delusional. It's empty calories either way. There are all sorts of candy and sweet cereal and pastries and chips and ice cream and mayonnaise-y salads and beer. You can get fat on that stuff just as well as on cheaper junk food.

Absolutely. I have a job that pretty much requires me to eat lunch (and sometimes dinner) out everyday--commuting between multiple schools, no office, etc., and, while it would be tempting to only spend $3.75 for a Wendy's #1 combo, I'd also weigh about 900 pounds if I did that on a regular basis. Eating nicely on a minimal basis in my area (i.e. Subway), puts me out about five bucks and change. To eat things with a little more green stuff in 'em runs at least seven bucks these days.

" On a recent trip to Panama, I noticed how much better the Coke tasted there than in the U.S. The reason is that they use actual sugar from actual sugarcane, instead of HFCS. "

It is possible to get real sugar in a soda these days (even at times other than Passover), but you have to go to Texas to do so:

Yeah, I think this reaction to corn syrup is weird. I remember 10 years ago when people acted like cane sugar was awful and high fructose corn syrup was the natural alternative. I remember saying to a very intelligent person believed this, "but it's still sugar." And she was all fructose, it's good for you, unlike sucrose. It's sugar processed from a plant, either way. Fear of corn is silly. Worrying about eating too many empty calories makes sense.

You do not have to eat lunch out. A peanut butter sandwich is cheap, nutritious and portable.

You don't have to eat processed food just because you're poor. Rice and beans (with a hambone thrown in for flavor) can feed a family of four for about two dollars. It's high in protein and low in calories and fat.

You don't have to join a gym to exercise. Walking is free.

Being fat -- except for a very rare few -- is a matter of consuming more calories than you burn. Reverse that to lose weight.